Summary of Benefits Life / AD&D Insurance New Life Option
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1 Summary of Benefits Life / AD&D Insurance New Life Option Basic Life All Active Full Time Employees (30 Hours) Flat $50,000 Medical Evidence Level: $50,000 Reduces by: 35% at Age 65, 50% at Age 70 Waiver of Premium (disabled prior to 60, waiting period 6 months, coverage continues to 65) Conversion is included in this quote Accelerated Benefit Option: 12 months or less to live, up to 80.0% of coverage, to a maximum of $500,000 Age Reduction*: The Employer is responsible for making sure that the offer of insurance to its Employees under the program described complies, if applicable, with the Age Discrimination in Employment Act of 1967, as amended, ("ADEA"), and the regulations thereunder. The Employer should seek the advice of counsel as to whether ADEA applies to the program and, if so, whether it is in compliance with ADEA and other applicable laws. MetLife is required to comply with insurance age discrimination laws where applicable. *All reductions are applied to the original benefit amount All Active Full Time Employees (30 Hours) 100% of the Basic Life benefit. Waiver of Premium (disabled prior to 60, waiting period 6 months, coverage continues to 65) Age Reduction*: The Employer is responsible for making sure that the offer of insurance to its Employees under the program described complies, if applicable, with the Age Discrimination in Employment Act of 1967, as amended, ("ADEA"), and the regulations thereunder. The Employer should seek the advice of counsel as to whether ADEA applies to the program and, if so, whether it is in compliance with ADEA and other applicable laws. MetLife is required to comply with insurance age discrimination laws where applicable. *All reductions are applied to the original benefit amount Rate per $1,000 of Covered Volume Est Volume Est Monthly Premium Est Annual Premium Basic Life $0.154 $600,000 $92 $1,109 Rates are guaranteed from April 1, March 31, 2018 (24 months) 1 $0.019 $600,000 $11 $137 Rates are guaranteed from April 1, March 31, 2018 (24 months) Please note that the MetLife AD&D insurance premium includes a fee for the Travel Assistance [and Identity Theft Solutions] services, provided by AXA Assistance USA, Inc. 1 Travel Assistance [and Identity Theft Solutions] services are administered by AXA Assistance USA, Inc. Certain benefits provided under the Travel Assistance program are underwritten by the United States Fire Insurance Company, a member of the Crum & Forster group of insurers. AXA Assistance and the Crum & Forster group are not affiliated with MetLife, and the services and benefits they provide are separate and apart from the insurance provided by MetLife.
2 Plan Features and Limitations Grief Counseling: Automatically included with Basic Life at no additional cost to the employer or employee. Available in all situs states except MD, NY and WA. Grief counseling is offered by Harris Rothenberg International, Inc 1. Grief counseling provides eligible employees, beneficiaries, spouses and other family members a form of counseling that aims to help people cope with grief and mourning following the death of a loved one, or with major life changes that trigger feelings of grief such as divorce, the loss of a job, financial hardship, terminal illness or loss of a pet. 1 Grief Counseling services are provided through an agreement with HRI, Inc. HRI, Inc. is not an affiliate of MetLife and the services HRI provides are separate and apart from the insurance provided by MetLife. Total Control Account (TCA): Death claim proceeds paid via the TCA Settlement Option - an interest-bearing account with draft-writing privileges Relieves beneficiaries of the need to make immediate decisions about what to do with a lump-sum check, while giving them the flexibility to access funds as needed and earn interest on the proceeds as they assess their financial situation Provides full and immediate access to the death proceeds Principal and interest earned are guaranteed by the financial strength and claims paying ability of the Metropolitan Life Insurance Company Beneficiary receives a draftbook, along with a Customer Agreement and other materials describing the Account Unlimited draft writing privileges No charges for processing TCA drafts, no monthly maintenance fees, and no charge for ordering additional TCA drafts Accountholders receive periodic statements itemizing account activity and a free Life Advice newsletter Information about the TCA is available electronically through MetLife s easy to use eservice web site Customer Service Representatives specially trained to provide service to beneficiaries are available through a special toll-free number At their convenience, Accountholders are able to touch or speak their requests into the phone such as, "hear account balance", "get recent transactions", and "order drafts." Subject to state law, and/or group policyholder direction, the TCA is provided for all Life and AD&D benefits of $5,000 or more. The TCA is not insured by the Federal Deposit Insurance Corporation or any government agency. The assets backing the TCA are maintained in the Metropolitan Life Insurance Company (MetLife) general account and are subject to MetLife s creditors. MetLife bears the investment risk of the assets backing the TCA, and expects to receive a profit. Regardless of the investment experience of such assets, the interest credited to Total Control Accounts will never fall below the guaranteed minimum rate. Guarantees are subject to the financial strength and claims paying ability of MetLife. Accelerated Benefits Option: If included, the minimum that can be accelerated is $20,000. The definition of earnings used to define benefits will be Basic Monthly Earnings. [ Waiver of Premium: Group life coverage is continued for an employee meeting the contractual definition of total disability. No further premium payment for that employee is required. The onset of the disability must occur prior to the age as defined in the Summary of Benefits. The disability must last continuously through the defined waiting period, and the employee must submit a request for the extension within 12 months of the onset of the total disability.
3 Enrolling in the Plan: A statement of health will need to be submitted by employees who: Request coverage amounts during their initial 31-day enrollment that exceed the stated MEOI level. Apply for coverage after the period which begins on the first day on which they are eligible for the coverage (or the first day following a qualifying event, if applicable) and ends at the earlier of the next following annual enrollment period or the day before the next following Policy Anniversary. In no event will this period be more than a year, or less than 31 days. Have indicated a medical condition on their enrollment form. Benefit Increases: Basic Life: Employees, Actively at Work, who are participating in the plan and want to increase their coverage by any amount will have to submit a statement of health. The coverage will be subject to a contestability clause in accordance with the law. No eligible individual may be covered more than once under this plan. If a person is covered as an employee, he/she cannot be covered as a spouse or dependent. If an employee and spouse are employed by the same employer, their eligible dependents may be insured as dependents of only one employee.
4 Table of Covered Losses for AD&D Covered Loss Life 100% Hand 50% Foot 50% Arm 75% Leg 75% Sight of One Eye 50% Combination of a Hand, Foot, and/or Eye 100% Thumb & Index Finger on the Same Hand 25% Speech and Hearing 100% Speech 50% Hearing 50% Paralysis of Both Arms and Both Legs 100% Paralysis of Both Legs 50% Paralysis of the Arm & Leg on Either Side of the Body 50% Paralysis of One Arm or Leg 25% Brain Damage 100% Coma 1% monthly up to 60 months * Maximum Amount payable for all Covered Losses sustained in one accident is capped at 100% of the Full Amount Additional Benefits Benefit Air Bag Use 5% up to $10,000 Seat Belt Use 10% up to $25,000 Common Carrier 100% of Full Amount Child Care Center $5,000 per year for 4 Yrs up to 12% of Full Amount
5 Limitations and Exclusions Limitations The Accidental Death & Dismemberment loss must occur within 365 days after the date of the accident and be a direct result of bodily injury sustained from that accident, independent of other causes. Exclusions Accidental Death & Dismemberment insurance does not include payment for any loss which in any way results from or is caused by or contributed to by: physical or mental illness or infirmity, or the diagnosis or treatment of such illness or infirmity; infection, other than infection occurring in an external accidental wound; suicide or attempted suicide; intentionally self-inflicted injury; service in the armed forces of any country or international authority. However, service in reserve forces does not constitute service in the armed forces, unless in connection with such reserve service an individual is on active military duty as determined by the applicable military authority other than weekend or summer training. For purposes of this provision reserve forces are defined as reserve forces of any branch of the military of the United States or of any other country or international authority, including but not limited to the National Guard of the United States or the national guard of any other country; any incident related to: 1) travel in an aircraft as a pilot, crew member, flight student or while acting in any capacity other than as a passenger; 2) travel in an aircraft for the purpose of parachuting or otherwise exiting from such aircraft while it is in flight; 3) parachuting or otherwise exiting from an aircraft while such aircraft is in flight except for self preservation; 4) travel in an aircraft or device used for testing or experimental purposes; by or for any military authority; or for travel or designed for travel beyond the earth s atmosphere; committing or attempting to commit a felony; the voluntary intake or use by any means of: 1) any drug, medication or sedative, unless it is: taken or used as prescribed by a Physician, or an "over the counter " drug, medication or sedative, taken as directed; 2) alcohol in combination with any drug, medication, or sedative; or 3) poison, gas, or fumes; war, whether declared or undeclared; or act of war, insurrection, rebellion, riot; driving a vehicle or operating another device while intoxicated as defined by the laws of the jurisdiction in which the vehicle or other device was being operated.
6 Highlights Broker Commissions included in the rate: Standard Scale Expected Participation: 100% Employee Contributions: 0% Situs is MARYLAND Financial Arrangement: Non-retrospectively Experience Rated Final rates will be based on actual enrollment and contribution levels. Submit complete enrollment materials by the 15 th of the month preceding the effective date to ensure prompt Underwriting review. Benefits terminate at retirement for: Basic Life AD&D Benefits terminate when the corresponding Life Benefits terminate. Actively at Work This quote assumes and is only valid if all covered employees will be Actively At Work on the Contract effective date. If you are or become aware of employees who will not be Actively at Work on the Contract effective date, please advise and provide us with a listing of Non-Actively at Work employees in a nonindividually identifiable manner, that includes age, gender, amount of insurance, date of, and reason for disability of all such disabled individuals, for risk evaluation.
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